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NPI Code Detail

MEDICARE: RESTORATIONS FOR LIFE MINISTRIES

MEDICARE: RESTORATIONS FOR LIFE MINISTRIES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPCC00015MN

General Provider Information

NPI Number : 1932428067
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATIONS FOR LIFE MINISTRIES
Provider Business Mailing Address
First Line : 5831 74TH AVE. N.
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443
Country : US
Telephone Number : 763-503-3747
Fax Number : 763-560-8148
Provider Business Practice Location Address
First Line : 5831 74TH AVE N
Second Line :
City : BROOKLYN PARK
State : MN
Zip : 55443-3109
Country : US
Telephone Number : 763-503-3747
Fax Number : 763-560-8148
Authorized Official
Title or Position : OWNER
Name : VICKI MARIE ROCHA
Credential : LPCC
Telephone Number : 763-503-3747
Provider Enumeration Date : 05/28/2010
Last Update Date : 05/28/2010

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Directions to “RESTORATIONS FOR LIFE MINISTRIES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.